Center for Public Health Research, San Francisco Department of Public Health, San Francisco, California, USA
School of Public Health, University of California Berkeley, Berkeley, California, USA.
Sex Transm Infect. 2020 Feb;96(1):58-61. doi: 10.1136/sextrans-2018-053609. Epub 2019 Jan 25.
Little is known about the sexual networks of young transwomen, leaving a major gap in what we know about transmission dynamics and the elevated rates of HIV in this population. The objective of this study was to understand partnership-level factors associated with condomless anal sex among young transwomen.
A secondary data analysis of the sexual partnerships of young transwomen was conducted using baseline data from the SHINE study. Generalised estimating equation logistic regressions were used to assess for partnership-level associations between partnership type, age, injection drug use and racial concordance, HIV seroconcordance, sexual role and condomless receptive (CRAI) and insertive anal intercourse (CIAI).
Our analysis included 187 young transwomen that reported a total of 464 sexual partnerships where they had at least one episode of anal sex in the past 6 months. We found casual (n=232 or 50%) and commercial partnerships (n=106 or 22.8%) to be significantly associated with a lower odds of CIAI (OR=0.53, 95% CI 0.32 to 0.86 and OR=0.39, 95% CI 0.18 to 0.82) and CRAI (OR=0.30, 95% CI 0.19 to 0.47 and OR=0.35, 95% CI 0.2 to 0.62) compared with main partnerships (n=126 or 27.2%). Additionally, HIV-positive seroconcordant (n=25 or 5.4%, OR=4.05, 95% CI 1.44 to 11.40) and injection-drug using partnerships (n=25 or 5.4%, OR=3.66, 95% CI 1.34 to 9.95) were found to be significantly associated with an increased odds of CIAI among participants compared with HIV-negative seroconcordant (n=330 or 71.1%) and non-using partnerships (n=338 or 72.8%), respectively.
Young transwomen, like other populations, engage in condomless sex more often with main than casual and commercial partners, suggesting a need for interventions that address sexual practices with steady main partners.
我们对年轻跨性别女性的性网络知之甚少，这使得我们对传播动态和该人群中 HIV 感染率升高的了解存在重大空白。本研究的目的是了解与年轻跨性别女性无保护肛交相关的伙伴关系层面因素。
利用 SHINE 研究的基线数据，对年轻跨性别女性的性伴侣关系进行二次数据分析。使用广义估计方程逻辑回归评估伙伴关系类型、年龄、注射吸毒和种族一致性、HIV 血清一致性、性角色以及无保护的接受性肛交（CRAI）和插入性肛交（CIAI）与伙伴关系层面之间的关联。
我们的分析包括 187 名年轻跨性别女性，她们在过去 6 个月内报告了总共 464 次性伴侣关系，其中至少有一次肛交经历。我们发现，偶然（n=232 或 50%）和商业性（n=106 或 22.8%）伙伴关系与 CIAI（OR=0.53，95%CI 0.32 至 0.86 和 OR=0.39，95%CI 0.18 至 0.82）和 CRAI（OR=0.30，95%CI 0.19 至 0.47 和 OR=0.35，95%CI 0.2 至 0.62）的可能性降低显著相关，而主要伙伴关系（n=126 或 27.2%）与之相比则显著降低。此外，HIV 阳性血清一致（n=25 或 5.4%，OR=4.05，95%CI 1.44 至 11.40）和注射吸毒伙伴关系（n=25 或 5.4%，OR=3.66，95%CI 1.34 至 9.95）与参与者中 CIAI 的可能性增加显著相关，与 HIV 阴性血清一致（n=330 或 71.1%）和非吸毒伙伴关系（n=338 或 72.8%）相比。
年轻跨性别女性与其他人群一样，与主要而非偶然和商业性伴侣发生无保护性行为的频率更高，这表明需要采取干预措施，解决与稳定主要伴侣的性行为实践问题。
